Schizophrenia DSM-V

Index
Criteria
Definition
Inducing Schizophrenia Type Symptoms
Psychotic Disorders
Treatment ( Psychotherapy )
Treatment ( Pharmacotherapy )
Schizophrenia Subtypes
Schizophrenia Diagnosis Flow Chart
Test for Schizophrenia CHN-E
Test for Schizophrenia v3.0
Schizophrenia Drug Checklist

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling. Schizophrenia (in Greek, “split mind") is a severe mental illness characterized by a variety of symptoms including but not limited to:

• loss of contact with reality
• bizarre behavior
• disorganized thinking
• disorganized speech
• decreased emotional expressiveness
• diminished or loss of contact with reality
• diminished to total social withdrawal
  
  Schizophrenia afflicts approximately one percent of the world's population, making it the most common psychosis. Schizophrenia is characterized by positive and negative symptoms. Fundamental symptoms include thought disturbance, withdrawal, and difficulties managing effect. Secondary symptoms include perception disorders such as hallucinations and grandiosity. Symptoms may also be non-schizophrenic in nature, including anxiety, depression, and psychosomatic symptoms.
  Schizophrenia is a severe, chronic brain disorder that alter the way a person acts, thinks, perceives reality, express emotions and relates to other people. Schizophrenia affects people of all gender and races. People suffering from Schizophrenia believe that other people have a capacity to read their mind, control their thought patterns or are scheming to harm them. In other cases, they may smell odors or hear voices that other people don’t smell or hear. These experiences leaves a person withdrawn, frightened of extremely agitated. Just like cancer or diabetes, Schizophrenia is a long life disease that has no known cure but it can be controlled with the correct treatment.
  Schizophrenia is a psychotic disorder in that a person may not differentiate the reality from imaginations; this usually leads to change in a person’s behavior and personality. When the change is sudden, it is referred to as psychotic episode. Sufferer of Schizophrenia experience different psychotic episodes during their lifetime, making the severity of the disorder to vary from one person to the other.

The diagnosis of schizophrenia as expanded in DSM-V

Criterion A now includes five items:

• Delusions
• Hallucinations
• Disorganized speech (e.g., frequent derailment or incoherence)
• Grossly disorganized or catatonic behavior
• Negative symptoms (i.e., diminished emotional expression or avolition)

At least two of the five symptoms must be present for at least one month. One of the two symptoms must be delusions, hallucinations, or disorganized speech. Negative symptoms, which impair function the most, are now official.

In discussing diagnostic features, the authors state that “no single symptom is pathognomonic of schizophrenia” and it is a “heterogeneous clinical syndrome”. This is what makes schizophrenia both fascinating and frustrating: Two people diagnose with schizophrenia may look and behave nothing like each other

.

Criterion B for schizophrenia gets more attention in DSM-5: “Level of functioning… is markedly below the level achieved prior to the onset”. This is not a criterion for schizoaffective disorder. (This is apparently unchanged from DSM-4.) Furthermore, the authors note that if symptoms of schizophrenia begin in childhood or adolescence, “the expected level of function is not attained. Comparing the individual with unaffected siblings may be helpful.” This must only amplify sibling rivalry.

The authors also comment that “individuals who had been socially active may become withdrawn from previous routines. Such behaviors are often the first sign of a disorder.” In the past few years, some studies have argued for treating people with who are at high risk of developing schizophrenia, even though they have not yet met diagnostic criteria.

This is controversial because we cannot predict who will definitely develop schizophrenia. Some treatments, such as antipsychotic medication, are not benign. This statement seems to permit more assertive treatment of youths who present with “prodromal” symptoms of schizophrenia.

Criterion C discusses the six-month duration that distinguishes “schizophrenia” from “schizophreniform disorder” (one to six months) and “brief psychotic disorder” (one day to six months).

Criterion D makes the distinction between schizophrenia and schizoaffective disorder (primarily psychosis and limited mood symptoms in schizophrenia). This is repeated multiple times under the entry for schizoaffective disorder.

Criterion E asks the reader to please rule out psychosis due to drugs or a medical condition.

Criterion F makes the distinction between schizophrenia and an “autism spectrum disorder or a communication disorder”. That replaces “pervasive developmental disorder” in DSM-4.

The previous specifiers for schizophrenia (paranoid, disorganized, catatonic, etc.) have disappeared; now, specifiers are related to the illness course (“first episode” versus “multiple episodes”; state of remission; etc.). People can and do get better from schizophrenia. (DSM states that 20% of people with schizophrenia have a “favorable course”.)

The authors also explicitly comment about “decrements” in cognitive function in people with schizophrenia, which frames the condition as a brain disease. Similarly, there’s a note that “unawareness of [schizophrenia in the patient] is typically a symptom of schizophrenia itself rather than a coping strategy.” It’s not a psychodynamic defense mechanism of denial.

It should be noted that the vast majority of persons with schizophrenia are not aggressive and are more frequently victimized than are individuals in the general population.

Late-onset cases (i.e., onset after age 40 years) are overrepresented by females, who may have married.” Why is that last part there? Is this meant as a consolation prize to their husbands?

DSM-5 officially concedes that “some minority ethnic groups” are more likely to be diagnosed with schizophrenia.

Substance-related disorders are high (over 50% smoke cigarettes regularly). They are also more likely to experience weight gain, diabetes, metabolic syndrome, cardiovascular and pulmonary disease. People with schizophrenia at high risk for suicide: 5-6% die by suicide and 20% attempt suicide. The combination of these factors may explain why people with schizophrenia die early compared to the general population.

Treatment ( Psychotherapy )

Adlerian Therapy
Behavior Therapy
Cognitive-behavioral Therapy
Existential Therapy
Gestalt Therapy
Person-centered Therapy
Psychoanalytic
Rational-emotive Therapy
Reality Therapy
Transactional Analysis

Treatment ( Pharmacotherapy )
Schizophrenia Drug Checklist
Schizophrenia Pharmacotherapy Treatment Information.

Clozaril
Compazine
Etrafon
Haldol
Haldol Decanoate
Inapsine
Lidone
Loxitane
Mellaril
Moban
Navane
Orap
Permitil
Prolixin
Prolixin Decanoate
Prolixin Enanthate
Proketazine
Risperdal
Serentil
Sparine
Stelazine
Taractan
Thorazine
Tindal
Trilafon
Vesprin